Endotracheal tube means

ABSTRACT

An endotracheal tube having a protrusion with small orifice at its forward end. An introducer or guide rod extends through the orifice to guide the tube between the vocal cords. The rod has a stop to limit its protrusion from the tube. A handle is provided on the rod to operate it.

United States Patent [191 Felbarg Aug. 28, 1973 [54] ENDOTRACHEAL TUBEMEANS 2,541,402 2/1951 Caine 128/351 3,511,243 5/1970 Toy 128/351 x [76]12 Kmgsley 3,175,557 3/1965 Hammond 128/351 Huntmgton, NY. 11 3,196,8767/1965 M1116: 128/343 [22] Filed: Feb. 22, 1972 [21] Appi. No.: 227,734

[52] US. Cl. 128/351, 128/341 7 [51] Int. Cl A61m 25/00 [58] Field ofSearch 128/10, 11, 341,

[56] References Cited UNITED STATES PATENTS 2,458,305 1/1949 Sandemi,128/348 Primary Examiner-Dalton L. Truluck Attorney-James P. Malone 2Claims, 8 Drawing Figures ENDOTRACIIEAL TUBE MEANS This inventionrelates to endotracheal tube means and more particularly to a novelversion for cases in which the regular tubes are difficult to insertbetween the vocal cords.

Endotracheal tubes are generally introduced through the nose or mouthbeyond the vocal cords and into the larynx and trachea. For this purposea laryngoscope is used.

Quite often this is readily accomplished by using an ordinaryendotracheal tube. In some cases, because of the patient having a smallmouth, protrudent teeth,

large tongue, etc., the operation may not be so easy and becomedifficult or impossible.

One of the difficulties in inserting the tube is that the tube is ofsuch caliber that blocks up all the available visual field or lumen ofthe laryngoscope instrument and the leading end of the tube cannot beseen nor the opening between the vocal cords. The operation ends upbeing ablind or almost blind intubation of the trachea. Tubes that aretransparent, made up of clear plastic, do not solve the problem.

The present invention provides means to be able to see the narrowopening between the vocal cords without interference from theendotracheal tube, comprising a introducer made up of a teflon rod orother suitable material..Teflon is desirable because it has adequatestiffnessand yet will bend easily should it encounter resistance toadvance, does not stick to rubber or plastic requiring littlelubrication for removal. It can also be bent to a desirable curvatureaccording to the needs of the particular case.

The introducer is inserted'inside the endotracheal tube and it isadjusted to extend forwardly beyond the distal end of the endotrachealtube several inches so that it can be seen easily in the laryngoscopefield.

Even if only part of the opening between the cords are seen it isreadily easier to insert the introducer rather than the much more largerendotracheal tube.

The introducer serves as a guide and the endotracheal tube will followeasily once the introducer is advanced between the vocal cords.

Accordingly, a principal object of the invention is to provide new andimproved guide means for inserting an endotracheal tube.

Another object of the invention is to provide new and improved guidemeans for inserting an endoctracheal tube having a teflon introducerextending through the tube and protruding from the distal portion of thetube.

Another object of the invention is to provide new and improved guidemeans for use in an endotracheal tube comprising an introducer, saidintroducer being adapted to be inserted through said tube and protrudefrom the distal end of said tube to permit visual guiding of said tubewhen said tube is inserted between the vocal cords and advanced into thetrachea.

These and other objects of the invention will be apparent from thefollowing specification and drawings of which:

FIG.- I is a side view of an endotracheal tube.

FIG. IA is an end view of FIG. 1.

FIG. 2 is a side view of the guide means.

FIG. 3 is a side view of the endotracheal tube with the guide meansinserted.

FIGS. 4 7 are diagrams illustrating the operation of the invention.

Referring to thefigures, FIG. I there is shown an en dotracheal tube 1which comprises a tubular member of rubber, plastic or latex with acontinuous spiral of nylon embedded-in the wall. I

Referring to the distal end of tube 1, it has a large opening I"obtusely cut in bevel which provides for the.

which could be blue colored. for easy detection in the laryngoscopefield over the generally pink background of the-pharynx. The teflon rod4 is mounted in a rubber sleeve 5, which at the upper end the introduceris ended in a handle 6.

The sleeve 5, on rod 4, increases the caliber of the teflon rod and bybearing against the orifice 3 limits the amount of protrusion of rod 4beyond the tip of the endotracheal tube.

Handle 6, is at the end of the same rubber sleeve 5, for easy grippingand quick removal of the introducer from inside the endotracheal tube.This is illustrated in FIG. 3 which shows the complete assembly.

The teflon rod 4, passes through the hole 3, in the protrusion 2 and thehandle 6 is shown before the fit ting la at the upper or proximal end ofthe tube 1. The introducer goes through orifice 3 somewhat tightly and asmall amount of a wetting agent such as diluted zephiran chloridesecures enough lubrication for removal.

In practice, referring to FIG. 4, the assembly. as shown in FIG. 3 isinserted through the laryngoscope'8. First the opening between the vocalcords 10 is located, and due to its small size the end 4' of theintroducer can be seen in the same visual field. This greatlyfacilitates the introduction of the assembly between the cords underdirect vision.

The operator, whose eye is 5 in the diagram, holds the laryngoscope 8with his left hand. The tube 1 assembly can be seen just about to enterbetween the vocal cords 10. As can be seen, the opening is very smalland the natural tendency for the tube if not visually guided will be tofall into the esophogus 9 which is a larger cavity where the larynx 7 islocated. The rest of the drawing shows the trachea l2 and the lungs 13,-13. This invention is not intended for blind intubation. If the vocalcords cannot be seen a regular tube would be better for blind attempts.

As the tube 1 assembly is advanced, FIG. 5, into the trachea, theintroducer 4, works as a guide. Once the tube is properly located, theintroducer is withdrawn completely from the tube 1, as shown in FIG. 6,and the supply tube 14 for the anesthetic may be connected to thefitting la, FIG. 7.

If this introducer is used with any of the presently availableendotracheal tubes the vocal cords will prevent the advance of theendotracheal tube 1 as none of them have a distal end adapted to threadand hold an introducer through and beyond the distal end.

It can be seen that tube 1 and introducer 4 form a unit and they adaptto each other especially at the distal end.

Once the introducer is beyond the vocal cords, by advancingftheassembly, tube 1 will gain its way in by riding over the cords by virtueof a very smooth transition of the two components. The conelike shape ofthe dis- 3 tal end of the tube allows for continuity of the twocomponents.

I claim:

1. A modified endotracheal tube having a tip; said tube having twoorifices in its tip, said tip having a large beveled orifice for the gaspassage duringventilation and a small orifice located next to andforwardly of said large orifice at the tip of a cone-like shapedprotrusion, an introducer plastic rod removably received within saidtube bore so that said rod distal end may extend several inches'from theend of said endot'rach'eal tube, said small orific'e being designed tothread and support s'aid introducer snuggly, said small orifice havingsuch dimensions as to allow easy threading yet support said introducer.

2. Apparatus as in claim 1 having a rubber sleeve mounted on the plasticrod, said sleeve extending dis tally up to the cone like shaped distalend of the endotracheal tube working as a stop to limit the protrusionof the introducer beyond the endotracheal tube and also causing theendotracheal tube to follow the introducer when said introducer ispushed forward into the trachea beyond the vocal cords, said sleeveextending proximally up to the end of the plastic rod working as ahandle, said handle being made with the purpose of providing an easygrip for the removal of said introducer.

s s a:

1. A modified endotracheal tube having a tip; said tube having twoorifices in its tip, said tip having a large beveled orifice for the gaspassage during ventilation and a small orifice located next to andforwardly of said large orifice at the tip of a cone-like shapedprotrusion, an introducer plastic rod removably received within saidtube bore so that said rod distal end may extend several inches from theend of said endotracheal tube, said small orifice being designed tothread and support said introducer snuggly, said small orifice hAvingsuch dimensions as to allow easy threading yet support said introducer.2. Apparatus as in claim 1 having a rubber sleeve mounted on the plasticrod, said sleeve extending distally up to the cone like shaped distalend of the endotracheal tube working as a stop to limit the protrusionof the introducer beyond the endotracheal tube and also causing theendotracheal tube to follow the introducer when said introducer ispushed forward into the trachea beyond the vocal cords, said sleeveextending proximally up to the end of the plastic rod working as ahandle, said handle being made with the purpose of providing an easygrip for the removal of said introducer.